The New G.O.P. Health-Care Plan Is So Bad Even Republicans Want Out

The zombie legislation formerly known as Trumpcare just won’t die, no matter how few voters—or even Republicans—seem to want it. While President Donald Trump previously declared the G.O.P. bill dead (“it’s enough already,” he sighed after House Speaker Paul Ryan abruptly pulled the vote last month), the House Freedom Caucus remains insistent on repealing Obamacare. And the White House, eager to put a big legislative win on the board, has been quietly facilitating negotiations to find a compromise between Republican conservatives and moderates.

Astonishingly, this concerted effort has yielded a revised repeal bill that is somehow even worse for poor and sick people than the original. It is, in fact, so toxic that even the architects of the legislation have reportedly included an amendment that would allow them and their staffers to opt out of the plan.

Trumpcare 1.0 was derailed because it was too cruel for moderate Republicans, who wanted to preserve many of Obamacare’s benefits, and too generous for conservatives, who wanted to gut them entirely. Trumpcare 2.0 attempted to bridge the issue by giving more concessions to conservatives, but the underlying problem remained. The crux of Trumpcare 3.0, which was introduced on Tuesday night, is an amendment that would split the difference by allowing states to choose whether to opt out of a number of popular Obamacare regulations. This includes the essential health benefits and community-rating provisions, which are intended to protect people with pre-existing conditions. As a trade-off, states would be required to set up high-risk insurance pools to help cover people whose insurance premiums might surge.

The new legislation has apparently won the support of much of the House Freedom Caucus, the arch-conservative group that has been pushing for a more threadbare plan. Politico reports that Representatives Dave Brat and Scott DesJarlais, both Freedom Caucus members who opposed earlier versions of the Obamacare repeal, have indicated that they would support legislation that dismantles some of the regulatory framework under the Affordable Care Act. Others, including Representatives Mo Brooks and Justin Amash, said they are taking the changes under consideration.

But while Representative Tom MacArthur, who helped broker the compromise, has said he is working to do “the right thing” for his constituents, neither he nor his colleagues apparently want to apply the legislation to themselves. Under current law, members of Congress and their staff are required to purchase insurance through the Obamacare exchanges. But as Vox notes, the Republicans who wrote the revised A.H.C.A. bill included a provision allowing members of Congress and their aides to retain the Obamacare regulations protecting individuals with pre-existing conditions from paying higher prices. A spokesperson for MacArthur confirmed to Vox that this was, in fact, the case.

Representative Mark Meadows, the chair of the House Freedom Caucus, reportedly rushed to shoot down the Vox report, denying that the exemption exists. The provision is, however, in the text. Later, when asked about the provision by reporters, Meadows argued that D.C. would have to be classified as a state for it to apply to members of Congress. Other G.O.P. Other House members demurred. “I didn’t know there was [an exemption for members of Congress]. I don’t know what you’re talking about,” Chris Collins said. Morgan Griffith dodged the question, telling reporters that he would “have to read the language more closely.” Brat at least, conceded that such an exemption would be “politically, completely tone deaf,” Talking Points Memo reports.

Even if the White House and House leadership were not facing a miniature P.R. crisis of their own making, prospects for Trumpcare 3.0 do not look bright. While MacArthur is the co-chair of the moderate Tuesday Group, it is unclear whether he actually speaks for other centrist Republicans in Congress. “MacArthur is kind of on his own,” one Tuesday Group member told Politico. Others said MacArthur did not get their blessing before negotiating on their behalf.

To pass the bill, the G.O.P. can’t lose any more than 23 votes in the House, as Democrats have created a unified front against the repeal effort. And the latest changes could cost leadership enough moderate votes to sink the bill—again. Charlie Dent, a co-chair of the Tuesday Group, said he is still opposed to the legislation. “Based on what I’ve read, it does not change my position. I was a no, and I remain a no,” the Pennsylvania congressman told the Washington Examiner. In a statement to Politico, Representative Leonard Lancesaid, “I ran in support of a plan that lowers premiums, increases access, and lowers health-care costs across the board. . . . Until I see a Congressional Budget Office score that says the revised bill achieves those goals I remain a 'no' vote.” And Representatives Dan Donovan and Frank LoBiondo indicated that the bill doesn’t address their main concerns with the original legislation.

Republicans are in a tough spot. After years of the G.O.P. deriding President Barack Obama’s signature health-care law and promising a repeal, public support for the Affordable Care Act is at an all time high. Only 37 percent of people said it should be repealed and replaced in a recent poll, and its popularity appears to be growing with each effort to dismantle it. By backing the latest iteration of the Republican repeal effort, which would likely result in greater coverage losses than the initial A.H.C.A., Republican lawmakers risk alienating their constituents and losing big at the ballot box in 2018. The fact that they don’t want to submit themselves or their staff to their own legislation is perhaps the most obvious admission that the central premise of the bill is fatally flawed.